Anabolic Steroids vs. Corticosteroids

Understanding the Different Types of Steroids

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Question:

The term steroid is often misunderstood. Corticosteroids (a class of drugs used to treat arthritis and many other conditions) are often just called "steroids". So what's in a name? Confusion results when they are mistaken for anabolic steroids (drugs used by athletes to boost strength and enhance physical performance). What is the difference between anabolic steroids and corticosteroids?

Answer:

According to the National Institute of General Medical Sciences, the term "steroid" is a chemical name for any substance that has a characteristic chemical structure consisting of multiple chemical rings of connected atoms.

Some common examples of steroids are:

  • Vitamin D
  • cholesterol
  • estrogen
  • cortisone

Steroids are critical for keeping the body running smoothly. Various steroids have important roles in the body's reproductive system and both the structure and function of membranes.

What Are Anabolic Steroids?

According to the National Institute on Drug Abuse, anabolic steroids are synthetic substances related to the male sex hormones (androgens). They promote the growth of skeletal muscle (anabolic effect) and the development of male sexual characteristics (androgenic effects).

The proper term for these compounds actually is "anabolic / androgenic" steroids:

  • “anabolic” refers to muscle-building
  • “androgenic” refers to increased masculine characteristics
  • “steroids” refers to the class of drugs

Anabolic steroids are available legally only by prescription, to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence.

They are also prescribed to treat body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass.

Anabolic steroids are being abused by some athletes and others to enhance performance or improve physical appearance. Abuse of anabolic steroids can lead to serious health problems, some of which are irreversible.

Major side effects can include:

  • liver tumors
  • cancer
  • jaundice
  • high blood pressure
  • kidney tumors
  • severe acne
  • trembling

In males, side effects may include shrinking of the testicles and breast development. In females, side effects may include the growth of facial hair, menstrual changes, and deepened voice. In teenagers, growth may be halted prematurely and permanently.

What Are Corticosteroids?

Corticosteroids or glucocorticoids, often just called "steroids", are drugs closely related to cortisol, a hormone which is naturally produced in the adrenal cortex (the outer layer of the adrenal gland). Corticosteroids act on the immune system by blocking the production of substances that trigger allergic and inflammatory actions, such as prostaglandins.

Corticosteroids include:

  • Betamethasone (Celestone)
  • Budesonide (Entocort EC)
  • Cortisone (Cortone)
  • Dexamethasone (Decadron)
  • Hydrocortisone (Cortef)
  • Methylprednisolone (Medrol)
  • Prednisolone (Prelone)
  • Prednisone (Deltasone)
  • Triamcinolone (Kenacort, Kenalog)

Corticosteroids (Steroids): Benefits vs. Risks

Corticosteroids are powerful drugs which can quickly reduce swelling and inflammation, greatly improve symptoms and provoke incredible results.

However, there are potential consequences and side effects. The power of corticosteroids should not be feared, but must be respected. To maximize benefits, but minimize potential side effects, steroids are usually prescribed in low doses or for short durations. The potent effect of corticosteroids can result in serious side effects which mimic Cushing's disease, a malfunction of the adrenal glands resulting in an overproduction of cortisol. The list of potential side effects is long and can include:

  • increased appetite and weight gain
  • deposits of fat in chest, face, upper back, and stomach
  • water and salt retention leading to swelling and edema
  • high blood pressure
  • diabetes
  • osteoporosis
  • cataracts
  • acne
  • muscle weakness
  • thinning of the skin
  • increased susceptibility to infection
  • stomach ulcers
  • psychological problems such as depression
  • adrenal suppression and crisis

Side effects are minimized by taking the lowest doses possible (that still yields positive results) and following doctor's orders. It is important to avoid self-regulation of the dosage, either by adding more or stopping the drug without a schedule. After prolonged use, steroids must be gradually reduced to permit the adrenal glands to resume natural cortisol production. Eliminating doses too quickly can result in glucocorticoid withdrawal symptoms, worsening of underlying inflammatory disease (rebound effect), or rarely, adrenal crisis (a life-threatening state caused by insufficient levels of adrenal steroids).

Corticosteroids - The Bottom Line

When your treatment plan involves one of the corticosteroid drugs, especially long-term, you should discuss and weigh the potential benefits versus the potential risks with your doctor. Sources:

NIDA InfoFacts: Steroids Anabolic-Androgenic, Medicines By Design NIH Pub. No. 03-474

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